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Release Notes:
Data Element
Version 2010A1

Data Element Name: Vital Sign Monitoring
Collected For: BM-05,
Definition:Documentation of blood pressure (BP) and temperature monitored at specific intervals for the transfusion. The intervals include: BP
  • Pre-transfusion, within 15 minutes of the initiation of the transfusion and within one hour of transfusion completion
Temperature
  • Pre-transfusion, during the transfusion and within four hours of transfusion completion
Suggested Data Collection Question:Was there documentation of BP and temperature monitored for all of the specified intervals for the transfusion?
Format:
Length:2
Type:Numeric
Occurs:1 -27
Allowable Values:

1    There was documentation for all of the BP AND temperature monitored intervals for the transfusion.

2    There was no documentation for all of the blood pressure and temperature monitoring intervals for the transfusion or unable to determine from medical record documentation.

Notes for Abstraction:
  • Blood pressure must be recorded at the following times: pre-transfusion, within 15 minutes of the initiation of the transfusion and within one hour of transfusion completion. Temperature must be recorded at all of the following times: pre-transfusion, during the transfusion and within four hours of transfusion completion. To select "1", all recordings must be documented.
  • The pre-transfusion BP and temperature must be within one hour of the Transfusion Start Time.
  • For platelets that may be transfused within 15 minutes, select 1 if the pre-transfusion and the within one hour of transfusion completion BP is documented.
  • Vitals documented at the completion of the transfusion are considered “within one hour of transfusion completion’.
  • The Vital Sign Monitoring must be associated with the blood product event ID that was selected for abstraction.
  • Up to three units (bags) of RBCs or doses of platelets or plasma can be abstracted per event.
Suggested Data Sources:
  • Anesthesia record
  • Consultation notes
  • Emergency department record
  • Nursing notes
  • Progress notes
  • Operative notes
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
None None

Vital Sign Monitoring
Specifications Manual for Joint Commission National Quality Core Measures (2010A1)
Discharges 04-01-10 (2Q10) through 09-30-10 (3Q10)